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Medical Forum / Diseases and Disorders / Diabetes / March 2008Taubes Presentation
Regina Wilshire has included a presentation by Gary Taubes on her latest blog: http://weightoftheevidence.blogspot.com/2008/02/gary-taubes.html It's long and I'm only into the first ten minutes but it's fascinating so far. Cheers, Alan, T2, Australia. d&e, metformin 1500mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraldiabetes.blogspot.com Latest: ACCORD, Foxes and Grapes Smarter to stop counting calories and instead eat less, down to the right amount: http://HeartMDPhD.com/BeSmart Be hungry... be healthy... be hungrier... be blessed: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com Swordbearer for the KING of kings and LORD of lords. http://HeartMDPhD.com/Sword > Regina Wilshire has included a presentation by Gary Taubes > on her latest blog: [quoted text clipped - 9 lines] > http://loraldiabetes.blogspot.com > Latest: ACCORD, Foxes and Grapes The Gary Taubes lecture can be viewed at Google video without using the link to the blogspot poster. He adds a few things that were not in the book, and reviews things in the book adding clarity and perspective. s.c.m. cut >The Gary Taubes lecture can be viewed at Google video without using the link >to the blogspot poster. > >He adds a few things that were not in the book, and reviews things in the >book adding clarity and perspective. Do you have a url? I had no problem watching it on Regina's blog, but it would have been nice to be able to expand the picture. Cheers, Alan, T2, Australia. d&e, metformin 1500mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraldiabetes.blogspot.com Latest: ACCORD, Foxes and Grapes try this: http://video.google.com/videoplay?docid=4362041487661765149&hl=en mikeV > s.c.m. cut > [quoted text clipped - 16 lines] > http://loraldiabetes.blogspot.com > Latest: ACCORD, Foxes and Grapes >try this: http://video.google.com/videoplay?docid=4362041487661765149&hl=en >mikeV Excellent. Thank you. Cheers, Alan, T2, Australia. d&e, metformin 1500mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraldiabetes.blogspot.com Latest: ACCORD, Foxes and Grapes >>try this: http://video.google.com/videoplay?docid=4362041487661765149&hl=en >>mikeV > > Excellent. Thank you. The larger screen helped a lot. A few days later I came across "New Insights into the Pathogenesis of Insulin Resistance in Humans Using Magnetic Resonance Spectroscopy" again and noticed parallels with the pictures Taubes presented related to fat distribution as well as it's absence - http://www.obesityresearch.org/cgi/content/full/14/suppl_1/34S. The parallels related to "obesity where the fat is stored centrally (android or apple shape distribution) is typically associated with insulin resistance. In contrast, when obesity is associated with fat stored around the hips (gynoid or pear shape distribution), insulin sensitivity remains normal (30)." Taubes also presented cases with severe lipodystrophy such as the women that was thin above the waist and obese below the waist. The researchers used magnetic resonance spectroscopy to dispel some long held theories/hypotheses such as Randle et al made in which "They speculated that increased fat oxidation was responsible for the insulin resistance associated with obesity and hypothesized that intracellular fatty acid accumulation would lead to an increase in the intramitochondrial acetyl coenzyme A (CoA)/CoA and NADH/NAD+ ratios, leading to inhibition of pyruvate dehydrogenase and increasing concentrations of intracellular citrate. The citrate accumulation would inhibit phosphofructokinase, a key rate-controlling enzyme in glycolysis, increasing intracellular glucose-6-phosphate concentrations and inhibiting hexokinase II activity. The inhibition of hexokinase II activity would result in an increase in intracellular glucose concentrations and decreased muscle glucose uptake. [...] A recent series of studies by our group have challenged this proposed mechanism of fat-induced insulin resistance (16). [...] In contrast to the prediction by the model proposed by Randle et al., where fat-induced insulin resistance would result in an increase in intramuscular glucose-6-phosphate concentrations, we found that the drop in muscle glycogen synthesis was preceded by a decrement in intramuscular glucose-6-phosphate concentrations." The side header provides subtopics in regard to insulin resistance such as "Defects in Mitochondrial Function Leading to Insulin Resistance" particularly with aging. Therapies that promote mitochondria biogenesis are apparently the way to improve mitochondria function, i.e., via resveratrol at physiological doses is a possiblity. Frank > A few days later I came across "New > Insights into the Pathogenesis of Insulin Resistance in Humans Using > Magnetic Resonance Spectroscopy" Wow. Great article. I'm about half through it. Not an article to be completely absorbed in one sitting; I'm learning a lot about insulin resistance. But, sheesh, a few diagrams of the pathways sure would have made this a lot easier. :-) Adam Becker sr Hi Adam: >> A few days later I came across "New >>Insights into the Pathogenesis of Insulin Resistance in Humans Using [quoted text clipped - 3 lines] > completely absorbed in one sitting; I'm learning a lot about insulin > resistance. To me, gene expression is a good clue. Note the importance of exercise when it comes to mitochondrial biogenesis. You asked a question related to that topic in another thread although you might not of used the same language. More research has been done in the area of gene expression in recent years since technology has evolved. About 40% of T2DMs offspring also end up with T2. The problem with the offspring is that they don't seem to want to hear the wakeup call. If I would have been more knowledgeable and put the knowledge into practice I believe I could have dodged the T2 bullet. ;) > But, sheesh, a few diagrams of the pathways sure would have made this > a lot easier. :-) Don't get the impression that I understand articles like this A to Z, but I do pick up enough by reading between the lines that I find them helpful. One does need to stretch the envelope more all the time. Frank SOME HEALTH AND MEDICAL RESOURCE LINKS - http://users.adelphia.net/~fwroy/medlinks.html GLOSSARY OF BIOCHEMICAL, MEDICAL CHEMISTRY, CELL BIOLOGY, AND DIABETIC TERMS - http://users.adelphia.net/~fwroy/glossary.html >Don't get the impression that I understand articles like this A to Z, >but I do pick up enough by reading between the lines that I find them >helpful. One does need to stretch the envelope more all the time. > >Frank Thanks Frank; nice to know you're mortal too:-) My envelope sometimes gets stretched ultra thin... Cheers, Alan, T2, Australia. d&e, metformin 1500mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraldiabetes.blogspot.com Latest: ACCORD, Foxes and Grapes >A few days later I came across "New >Insights into the Pathogenesis of Insulin Resistance in Humans Using >Magnetic Resonance Spectroscopy" again and noticed parallels with the >pictures Taubes presented related to fat distribution as well as it's >absence - http://www.obesityresearch.org/cgi/content/full/14/suppl_1/34S. An interesting paper - thanks, Frank! Nothing new, but I liked this bit: "We next examined whether chronic exercise training could reverse this defect in glucose transport/phosphorylation activity (10) . Over a period of 6 weeks, a similar cohort exercised 40 minutes four times a week on a Stairmaster (Nautilus, Inc., Vancouver, WA) at 65% of their VO2max. After this exercise regimen, insulin sensitivity and insulin-stimulated muscle glycogen synthesis normalized in the insulin-resistant offspring, and this could be attributed to correction of their defects in muscle glucose transport/phosphorylation activity. The results of this study strongly suggest that aerobic exercise might be useful in reversing insulin resistance in these pre-diabetic individuals and that it may prevent the development of type 2 diabetes. " Again not new, but reprinted for Kurt and Reisa: "The reduction in mitochondrial function and lipid accumulation in muscle and liver can likely be ascribed to an age-associated reduction in mitochondrial content caused by accumulated mutations in mtDNA, which have been described to occur with aging (39) . In more recent studies, using the same 31P MRS techniques to assess rates of ATP synthesis in skeletal muscle, we found similar reductions in mitochondrial activity associated with an increase in intramyocellular lipid content in young, lean, insulin-resistant offspring of parents with type 2 diabetes, a group that has a strong tendency to develop diabetes later in life (40) . These alterations in mitochondrial function are consistent with studies that have shown reductions in the activity of rotenone-sensitive NADH:O (2) oxidoreductase in isolated muscle mitochondria obtained from type 2 diabetic subjects (41) . Taken together, these data suggest that alterations in nuclear encoded genes that regulate mitochondrial biogenesis may form the genetic basis for inheritance of type 2 diabetes (42) (43) (44) (45) ." I particularly liked the way they were working through the logic of each step, and rejecting (most of) the inconsistencies. Nicky. T2 dx 05/04 + underactive thyroid D&E, 100ug thyroxine Last A1c 5.6% BMI 25 >>A few days later I came across "New >>Insights into the Pathogenesis of Insulin Resistance in Humans Using [quoted text clipped - 15 lines] > resistance in these pre-diabetic individuals and that it may prevent > the development of type 2 diabetes. " I was thinking about you when I read this part of the article. Between you and some other T2s your exercise routines for both endurance and strength may also reverse insulin resistance (in at least milder T2). I also believe some change in gene expression can take place. IMO, to some extent the pathologies of T2 can be reversed but not complete overcome by various therapies including diet, exercise, meds, and supplements. > "In more recent > studies, using the same 31P MRS techniques to assess rates of ATP [quoted text clipped - 3 lines] > with type 2 diabetes, a group that has a strong tendency to develop > diabetes later in life (40)." More info on intramyocellular lipids and skeletal muscle tissues: Intramyocellular Lipid Is Associated With Resistance to In Vivo Insulin Actions on Glucose Uptake, Antilipolysis, and Early Insulin Signaling Pathways in Human Skeletal Muscle - http://diabetes.diabetesjournals.org/cgi/content/full/50/10/2337 "Recently, several studies have shown an association between lipid accumulation in skeletal muscle and insulin resistance (4,5,6,7,8,9,10). In four of these studies, this relation was shown to be caused by intramyocellular rather than extramyocellular lipids, as measured by proton spectroscopy (5,6,7,11). [...] Because women appear to have more IMCL than men for the same BMI (11) but similar insulin sensitivity, despite greater adiposity (% body fat) than men with similar BMI (14), a lack of a correlation between IMCL and insulin sensitivity may have been confounded by the mixing of sexes." More research has been done on this topic since 2001. There are a number of articles citing this article - http://tinyurl.com/34c668 > I particularly liked the way they were working through the logic of > each step, and rejecting (most of) the inconsistencies. Shulman goes back to the offspring of T2s to try and see how T2s depart from normal glycemia. Gerald Shulman search - http://tinyurl.com/2u7uw2. Frank >>A few days later I came across "New >>Insights into the Pathogenesis of Insulin Resistance in Humans Using [quoted text clipped - 3 lines] > >An interesting paper - thanks, Frank! As always. Thanks to Frank also for his useful glossary. <snip> >Again not new, but reprinted for Kurt and Reisa: >"The reduction in mitochondrial function and lipid accumulation in [quoted text clipped - 13 lines] >genes that regulate mitochondrial biogenesis may form the genetic >basis for inheritance of type 2 diabetes (42) (43) (44) (45) ." Now that IS interesting, looking at the way both overt diabetes and insulin resistance seems to run in our family especially among lean fit people. The exercise does have an effect, but only in delaying the inevitable rather than preventing it. Old Al was right, an unwise choice of grandparents. :( > Now that IS interesting, looking at the way both overt diabetes and > insulin resistance seems to run in our family especially among lean > fit people. Hmm... familial diabetes, lean subjects. That sounds familiar. http://www.phlaunt.com/diabetes/14047009.php MODY - It's Not Type 1 and Not Type 2, but Something New Up to 20% of people diagnosed with Type 2 diabetes are not overweight. If you are one of them, it's worth doing some research to make sure that you don't, in fact, have another kind of diabetes, one that many doctors don't even know about. This kind of diabetes, called "Maturity Onset Diabetes of the Young" is a genetic form of diabetes causing failure of the beta cells, It is believed to affect up to 5% of all people diagnosed with both type 1 and type 2 diabetes. RTWT Adam Becker Sr >> Now that IS interesting, looking at the way both overt diabetes and >> insulin resistance seems to run in our family especially among lean [quoted text clipped - 12 lines] >believed to affect up to 5% of all people diagnosed with both type 1 >and type 2 diabetes. Lots of stuff being done at Exeter Uni: http://www.projects.ex.ac.uk/diabetesgenes/mody/index.htm Nicky. T2 dx 05/04 + underactive thyroid D&E, 100ug thyroxine Last A1c 5.6% BMI 25 >>> Now that IS interesting, looking at the way both overt diabetes and >>> insulin resistance seems to run in our family especially among lean >>> fit people. >> >>Hmm... familial diabetes, lean subjects. That sounds familiar. >> http://www.phlaunt.com/diabetes/14047009.php It does indeed. Matches me to a 'T'. I'm not - and never have been - much overweight. And for the last 7 years I've watched my weight even more as part of my psoriatic arthritis treatment. On the familial side - my mother is T2 as is her brother (she was diagnosed about 2 years before me and he about 6 months after me). >>This kind of diabetes, called "Maturity Onset Diabetes of the Young" >>is a genetic form of diabetes causing failure of the beta cells, It is [quoted text clipped - 3 lines] > Lots of stuff being done at Exeter Uni: > http://www.projects.ex.ac.uk/diabetesgenes/mody/index.htm Hmm. I'll mention it to the docter this afternoon Phil  SignaturePhil Launchbury, IT PHB 'I'm training the bats that live in my cube to juggle mushrooms' >> Now that IS interesting, looking at the way both overt diabetes and >> insulin resistance seems to run in our family especially among lean [quoted text clipped - 12 lines] >believed to affect up to 5% of all people diagnosed with both type 1 >and type 2 diabetes. Oh I know, I've read that, and much of the Exeter site Nicky points to below, but it doesn't match any of the MODYs exactly enough to be diagnostic. I think it was Ted (or Herman) who pointed out it is simply not true that Type 2 in children has only recently started to occur - but has only recently started to be *diagnosed*. I suspect much the same is true of non-Type-1 diabetes in slim people, I've seen figures that 5 - 20% of Type 2s are non-obese but find it hard to trust any such numbers as being more than a wild guess, if only obese people are tested who will know? This seems to be a familial insulin resistance phenomenon, almost certainly genetic, probably a different gene or gene set which they'll probably get round to identifying in due course. I'll leave the remnants of my body to science. > I've seen figures that 5 - 20% of Type 2s are non-obese but find it <Waves> I'm not (and never have been) obese. I'm 6 foot tall and have only once in my life been over 13 stone (drinking 5-6 full-fat Cokes a day at work) and that weight came off when I switched to drinking water instead. I'm currently just over 12 stone. > This seems to be a familial insulin resistance phenomenon, almost > certainly genetic, probably a different gene or gene set which they'll > probably get round to identifying in due course. Mother is T2, her brother is T2 and (I think) her mother was too. Add the psoriasis inherited from both sides (expressed both as psoriasys and psoriatic arthritis) and I have one fairly messed-up immune system. It does mean I hardly ever get colds though.. > I'll leave the remnants of my body to science. Likewise. It's only other use would be fertiliser and I'm not sure that the plants would appreciate the suphasalazine I've been taking for the last 4-5 years.. Phil. SignaturePhil Launchbury, IT PHB 'I'm training the bats that live in my cube to juggle mushrooms' >> I've seen figures that 5 - 20% of Type 2s are non-obese but find it > [quoted text clipped - 4 lines] >work) and that weight came off when I switched to drinking water >instead. I'm currently just over 12 stone. they have lo-fat cokes? SignatureMåck©® Deltec CoZmore Pumper Type 1 since 1975 http://www.alt-support-diabetes.org http://www.diabetic-talk.org http://www.insulin-pumpers.org http://diabetes.niddk.nih.gov/dm/pubs/type1and2/ http://www.pandora.com enter "Jason & Demarco" http://www.ratbags.com/dechunging/ "To announce that there must be no criticism of the President, or that we are to stand by the President right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public." ...Theodore Roosevelt (o ô) --ooO-(_)-Ooo-------------------- "I don't know half of you half as well as I should like; and I like less than half of you half as well as you deserve." ....Bilbo Baggins DISCLAIMER If you find a posting or message from me offensive, inappropriate, or disruptive, please ignore it. If you don't know how to ignore a posting, complain to me and I will be only too happy to demonstrate... . >>in my life been over 13 stone (drinking 5-6 full-fat Cokes a day at >>work) and that weight came off when I switched to drinking water >>instead. I'm currently just over 12 stone. > they have lo-fat cokes? Shorthand for cokes-with-sugar rathern than diet cokes.. Phil SignaturePhil Launchbury, IT PHB 'I'm training the bats that live in my cube to juggle mushrooms' >>>in my life been over 13 stone (drinking 5-6 full-fat Cokes a day at >>>work) and that weight came off when I switched to drinking water [quoted text clipped - 5 lines] > >Phil Also known as leaded and unleaded sodas. -- BettyB -- www.flamingo-code.com "I have noticed even people who claim everything is predestined, and that we can do nothing to change it, look before they cross the road." - Stephen Hawking >>> they have lo-fat cokes? >> >>Shorthand for cokes-with-sugar rathern than diet cokes.. > Also known as leaded and unleaded sodas. > -- I thought that was for with & without caffeine. Or am I forgetting what that's called? bj >>>>in my life been over 13 stone (drinking 5-6 full-fat Cokes a day at >>>>work) and that weight came off when I switched to drinking water [quoted text clipped - 7 lines] > >Also known as leaded and unleaded sodas. now that one makes more sense. I used to wait tables. However we all know that low-fat frequently equates to more carbs. So you do the math. SignatureMåck©® Deltec CoZmore Pumper Type 1 since 1975 http://www.alt-support-diabetes.org http://www.diabetic-talk.org http://www.insulin-pumpers.org http://diabetes.niddk.nih.gov/dm/pubs/type1and2/ http://www.pandora.com enter "Jason & Demarco" http://www.ratbags.com/dechunging/ "To announce that there must be no criticism of the President, or that we are to stand by the President right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public." ...Theodore Roosevelt (o ô) --ooO-(_)-Ooo-------------------- "I don't know half of you half as well as I should like; and I like less than half of you half as well as you deserve." ....Bilbo Baggins DISCLAIMER If you find a posting or message from me offensive, inappropriate, or disruptive, please ignore it. If you don't know how to ignore a posting, complain to me and I will be only too happy to demonstrate... . >> I've seen figures that 5 - 20% of Type 2s are non-obese but find it > [quoted text clipped - 13 lines] >and psoriatic arthritis) and I have one fairly messed-up immune system. >It does mean I hardly ever get colds though.. Yes as in our family this suggests multiple genes rather than a monogenic cause. Well I suppose the diabetes itself might be monogenic but the autoimmune component (which is actually usually associated with Type 1 rather than Type 2) it a different thing. Do these conditions only occur in *some* individuals, skip generations, etc? >> I'll leave the remnants of my body to science. > >Likewise. It's only other use would be fertiliser and I'm not sure that >the plants would appreciate the suphasalazine I've been taking for the >last 4-5 years.. Mother takes that for the remnants of her Crohn's (autoimmune again, but she's the only sufferer in the family AFAIK). We do get colds and other minor illnesses (though I haven't had flu for years which makes me wonder what it'll be like when it finally does catch up with me. However cancer is almost non-existent in BOTH sides of the family. So it goes . . . >>> This seems to be a familial insulin resistance phenomenon, almost >>> certainly genetic, probably a different gene or gene set which they'll [quoted text clipped - 10 lines] > with Type 1 rather than Type 2) it a different thing. Do these > conditions only occur in *some* individuals, skip generations, etc? Well - I have 3 older brothers and non of them test as t2 diabetic. And non of them have psoriasis/PA either. Guess I got lucky. >>Likewise. It's only other use would be fertiliser and I'm not sure that >>the plants would appreciate the suphasalazine I've been taking for the >>last 4-5 years.. > > Mother takes that for the remnants of her Crohn's (autoimmune again, > but she's the only sufferer in the family AFAIK). And as I discovered recently has a significant action on the A1C value (reduces it by 1.8 according to the study I read and the dosages I'm on). Phil SignaturePhil Launchbury, IT PHB 'I'm training the bats that live in my cube to juggle mushrooms' >>>> This seems to be a familial insulin resistance phenomenon, almost >>>> certainly genetic, probably a different gene or gene set which they'll [quoted text clipped - 15 lines] > >Guess I got lucky. That would be the one. :( >>>Likewise. It's only other use would be fertiliser and I'm not sure that >>>the plants would appreciate the suphasalazine I've been taking for the [quoted text clipped - 6 lines] >(reduces it by 1.8 according to the study I read and the dosages I'm >on). Interesting. She gets high (but not technically diabetic) BGs off prednisolone, so far reversible, maybe the sulphasalazine helps protect her from their worst effects. > Regina Wilshire has included a presentation by Gary Taubes > on her latest blog: [quoted text clipped - 9 lines] > http://loraldiabetes.blogspot.com > Latest: ACCORD, Foxes and Grapes He makes a very compelling argument but then what...... BigBird > Regina Wilshire has included a presentation by Gary Taubes > on her latest blog: [quoted text clipped - 9 lines] > http://loraldiabetes.blogspot.com > Latest: ACCORD, Foxes and Grapes Alan. Thanks for this. We all knew how the lecture would end but explication of the utter blindness of the proponents of calorie reduction despite their own knowledge of the fat storing properties of insulin and carbs was entertaining as hell. > > Regina Wilshire has included a presentation by Gary Taubes > > on her latest blog: [quoted text clipped - 7 lines] > reduction despite their own knowledge of the fat storing properties of > insulin and carbs was entertaining as hell. Folks counting calories are blind because they suffer from the false belief that they know the calorie content of the foods they are eating. Only folks who are counting ounces are not delusional: http://HeartMDPhD.com/BeSmart Be hungry... be healthy... be hungrier... be euglycemic: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com Brethren of the KING of kings and LORD of lords. http://HeartMDPhD.com/ChristianBrethren > > > Regina Wilshire has included a presentation by Gary Taubes > > > on her latest blog: [quoted text clipped - 11 lines] > belief that they know the calorie content of the foods they are > eating. Folks filling their tank are blind because they suffer from the false belief that they know the octane rating of the fuel they are purchasing. -- cary |
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